Bouncing Numbers

[Julie & steve j]

Our lovely cat Benny was diagnosed diabetic last September. Three weeks ago his Prozinc was increased to 5 units. Reason being that his numbers were still high on 4.5 units and he has developed a neuropathy in his hind legs which has resulted in him not being able to jump above 2 feet, and unsteady walking.

Since the increase to 5 units we have seen numbers as low as 6.4 around nadir (9 days after increase), but 3 weeks on, we have started to see readings of 26 in the morning (2.5 hours after insulin) and in the afternoon (3 hours prior to insulin).

We are now at a loss to understand why the readings have jumped back to high levels again as we haven't changed his diet, which consists of dry diabetic food and a couple of small portions of tuna. His water consumption is around normal levels now, (approx 300 mls per day) and he has been gaining weight since end of last year.

We can't help but wonder if perhaps Prozinc isn't the best insulin for Benny. Our concern is that we don't want to see any further deterioration in his neuropathy, but the last vet we saw suggested that diabetes may not have been the cause, only exacerbated the problem. Our Vet would like us to complete a full 12 hour curve test at home but we are struggling with this. Benny gets very stressed, and the last time we tried for a curve, he got so stressed his numbers started going up not down so we abandoned the testing. A different vet has suggested doing just one reading per day gives better results. How often do people generally take readings from their cats?

 

[Bama Kitty Mom (GA)]

Sorry this is such as issue for you and Benny. I test Bama's BG twice per day just before feeding and then I give his insulin shot. He has been on Novolin N since his diagnosis in the fall of 2014. Occasionally I do a mid-cycle test to see how low his insulin is taking him but I rarely do full 12 hour curves. Too stressful for me! Bama doesn't like it much either. He is used to the twice per day testing. Since I test so regularly, it has become less stressful for both of us. You might try posting in the Prozinc forum so those who are familiar with that insulin will be more likely to respond.

 

[Bron and Sheba (GA)]

Hi Julie, Steve and Benny
I am really glad you are testing the blood sugars.
I don't agree with testing just once a day and that will get better results......all that does is to ignore all the other tests in a day and only having the one test to be concerned about ....I'd call that putting your head in the sand

There are a few things that you can do. First of all I would ditch the dry food altogether. Even if it is diabetic dry food it will be at least 16 or 17% carbs which is considered high carb for cats. Prescription food is not necessary. It is expensive and has nothing special in it. Look for some low carb canned food 10% or under carbs, from this list below. Choose the list from your country
http://www.felinediabetes.com/FDMB/threads/links-to-food-charts.174182/

However before you change over the food, make sure you can monitor the blood sugars as they can drop up to 100points with the change over to low carb. Also I would look at how much tuna you are feeding. Feeding fish to cats more than just occasionally is not recommended. We can help you with the change over.
I would also recommend you set up a spreadsheet and put in all the numbers you have already. It is a great SS and we look at it each time we help you. Itis amazing what we can tell from a SS. Here is the link. If you have any trouble with setting it up, we can help you.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Getting numbers during the cycles during the days and nights is better than one cycle because that one cycle could be a higher than normal cycle or a lower than normal cycles.....all cycles are different. Getting random numbers helps fill in the jigsaw....does that make sense., have a look at a few cats spreadsheets which you can access by looking at the signature at the bottom of individual post. Most People test before every shot and then at least once towards the middle of the cycle to see how low the insulin is taking kitty. Some test more often ..
Also would you be able to set up your signature which is easy. Just go to the top right of this page and click on your username and choose signature. Tell us yours and kitties name, date of diagnosis, type of insulin and meter used, any other illnesses and medications, weight, and type of food fed. This will be seen at the bottom of all your posts and helpers won't have to ask a lot of questions before assisting you. Thanks.
Before swapping the insulin I would change over to a low carb canned diet, set up a spreadsheet and see if that changes the numbers. I am going to tag @Rachel as she is an experienced Prozinc user.
Bron

 

[MindyC]

Our lovely cat Benny was diagnosed diabetic last September. Three weeks ago his Prozinc was increased to 5 units. Reason being that his numbers were still high on 4.5 units and he has developed a neuropathy in his hind legs which has resulted in him not being able to jump above 2 feet, and unsteady walking.

Since the increase to 5 units we have seen numbers as low as 6.4 around nadir (9 days after increase), but 3 weeks on, we have started to see readings of 26 in the morning (2.5 hours after insulin) and in the afternoon (3 hours prior to insulin).

We are now at a loss to understand why the readings have jumped back to high levels again as we haven't changed his diet, which consists of dry diabetic food and a couple of small portions of tuna. His water consumption is around normal levels now, (approx 300 mls per day) and he has been gaining weight since end of last year.

We can't help but wonder if perhaps Prozinc isn't the best insulin for Benny. Our concern is that we don't want to see any further deterioration in his neuropathy, but the last vet we saw suggested that diabetes may not have been the cause, only exacerbated the problem. Our Vet would like us to complete a full 12 hour curve test at home but we are struggling with this. Benny gets very stressed, and the last time we tried for a curve, he got so stressed his numbers started going up not down so we abandoned the testing. A different vet has suggested doing just one reading per day gives better results. How often do people generally take readings from their cats?

You can take a walk through some of the insulin-specific boards and look at the spreadsheet links in everyone's signatures to get an idea of how often they test. Minimum testing is just before every shot, so twice/day. For those of us that have come to an agreement with our kitties to be patient for tests (treats help a LOT!), we test whenever we can. I have two kids (9 and 11), 2 dogs, 2 cats, and a job that ranges from mostly part-time to sometimes full-time (project based work...ya gotta take it when it comes!)...and I have all the activities that go along with being mom, which means there are days I'm not here except at shot time, because I haven't gotten my husband into the mix to help with testing/shooting. I'll be gone for a week at the end of May, so he'll have to be on board with it by then! ;-) Hopefully we'll have him better regulated by then and hubs can get by with just testing at shot time.

Anyway...as for the insulin, that would be a discussion to have with your vet. We started with Novolin for Max this round because of how sick he was at diagnosis and his age and the cost of other insulins. I also didn't expect remission this time around, and was really hoping we could get decent regulation on a cheaper insulin. I knew as soon as his antibiotics started working we probably should have switched to Lantus (his original diagnosis was 9 years ago, and 6 weeks of Lantus got him into remission), but due to the way Lantus works and knowing we were approaching a 10-day vacation where he would get shots but not be tested, we didn't switch him until after we got back.

Your vet can test and adjust doses without you testing at home...but I don't know that very many kitties go into remission with that approach. Home testing is the way to go, because then you can see what is happening during a shot cycle, and know just how low (or not) your kitty's glucose actually goes. The data you gather with home testing can help with judging whether the insulin you're using is actually effective for your cat, and gives you some leeway in adjusting the dose without a call or visit to the vet.

For the neuropathy, have you looked into B12 supplements? Someone here advised me about them when we first started the insulin again with Max because of litter box issues, and while I think they supplements help overall, I'm not sure he actually has neuropathy. He does have arthritis, so I need to put a call back in to the vet to discuss options for that. The nice thing about B12 is it is a water-soluble vitamin, so any of it that they don't use gets passed through in the urine. No overdose issues. Zobaline is a brand name for an unflavored (and unsweetened) B12 suppliment that is made for diabetic cats. It's a dissolvable tablet, and easy to give. Max does seem to have a bit more energy on the days I remember to give it to him.

 

[Rachel]

I'm so sorry to hear that things are so tough right now. It's really hard to take care of a diabetic cat with all the different advice you get from everyone, I know. I'd strongly encourage you to test Benny before every shot (always) and get whatever mid cycle tests you can in. With Prozinc, we decide on a dose based on preshot AND nadir values, so you really do need both when you can get them. Basically, we want to see how high a cat is before a shot, how low that shot takes them, and how high they end up. That way, we know if a dose is going low enough or is keeping them in fairly flat numbers. The good news is that you don't have to get a nadir every day...just when you can. And on days you can't, you want to grab any other tests...like a +2 on the way out the door or a +3 before bed. Any data helps.

As Bron said, ditching the dry food will probably help.

It's possible that Benny is bouncing from low numbers...are you still able to get nadirs? Have they been low like before or are they pretty high too? If you can let us know some numbers you are getting, that would help. You can list them out by using AMPS (am preshot) PMPS (pm preshot) and then +1 +2 and so on....the plus numbers are hours after the preshot test. That way we don't have to worry about timezones making it harder for us.

If you could get a spreadsheet up and running and fill it in as much as possible, that would be a HUGE help for us to tell some patterns and maybe figure out more of what is going on.

Please do feel free to come over to the Prozinc forum too! I don't get out to Main much because of time constraints and since most people using Prozinc post in that forum, I usually hang out there, as do several others who would be happy to help!